OBJECTIVES: The Adult Social Care Outcomes Toolkit Four-Level Self-completion Tool (ASCOT-SCT4) is a preference-based instrument developed to measure long-term care (LTC) related quality of life. This project aims to conduct a cultural adaptation study with two stages: (1) translate the ASCOT-SCT4 into Chinese; and (2) evaluate its psychometric characteristics in Hong Kong.

METHODS: The translation for the cultural adaptation process followed international guidelines. Cognitive debriefing interviews were conducted among 27 older adults receiving LTC services to assess the linguistic and content validity. This translated instrument was also reviewed by an independent expert panel. The instrument was later administered to a sample of older adults using LTC services to assess the construct validity.

RESULTS: The cognitive interviews demonstrated the translated instrument was generally understood as intended and easy to complete. However, the items ‘Control’ and ‘Dignity’ were found to be linguistically challenging to understand in everyday Chinese language. In the cross-sectional validation survey, 71 participants using home and/or community care services were recruited. The mean age was 73.6; 81.5% were female, 45.0% living alone, 87.7% had chronic conditions. Ceiling effects (>15%) were found in all items. Moderate positive correlations were found between ASCOT-SCT4 scores and EQ-5D index (r=0.47, p<0.01), CASP-12 (r=0.49, p<0.01), and a moderate negative correlation was observed between ASCOT-SCT4 and PHQ-9 (r=-0.40, p<0.01). Known-groups analyses indicated significantly worse ASCOT-SC4 scores for participants with depression than those without, and for participants with limitations in (instrumental) activities of daily living than those without. However, no significant differences were found between participants living alone and those living with others.

CONCLUSIONS: The preliminary results partially support the content validity, convergent validity, and known-group validity of the Chinese version of ASCOT-SCT4. Sample recruitment for the validation survey is ongoing to establish the construct validity and other psychometric properties, such as structural characteristics and test-retest reliability.